The SGLT2 inhibitors are the newest class of hypoglycaemic agents and have been used increasingly frequently because of their efficacy, oral route of administration and added effects of weight loss and a small but significant reduction in blood pressure. Their insulin independent mode of action has meant that they can be used irrespective of β cell mass and therefore are not limited to early in the pathogenesis of T2DM. The side effect profile is well recognised with urogenital infections the most obvious (although relatively infrequent in clinical practice). However, recently, there have been reports of ketoacidosis in patients on these drugs. As of mid May 2015, the European Medicines Authority have reported a total of 101 cases of diabetic ketoacidosis in patients treated with SGLT2 inhibitors for type 2 diabetes.